The complexity of sensorimotor control required for hand function as well as the wide range of recovery of manipulative abilities makes rehabilitation of the hand most challenging. Our past work has shown that training in a virtual environment (VE) using repetitive, adaptive algorithms has the potential to be an effective rehabilitation medium to facilitate motor recovery of hand function. These findings are in accordance with current neuroscience literature in animals and motor control literature in humans. We are now in a position to refine and optimize elements of the training paradigms to enhance neuroplasticity. Our first aim tests if and how competition among body parts for neural representations stifles functional gains from different types of training regimens. The second aim tests the functional benefits of unilateral versus bilateral training regimens. The third aim tests whether functional improvements gained from training in a virtual environment transfer to other (untrained) skills in the real world. PUBLIC HEALTH RELEVANCE: The potential benefit of this study will be to provide more targeted therapeutic interventions so as to maximize recovery of function in the hemiplegic hand of patients who have had a stroke. The study will use interactive virtual reality-based gaming simulations to encourage the intensity of practice needed for motor recovery. Information gained will help to uncover the potential benefits of these interventions on facilitating recovery of hand function.